| NPI | 1104144013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: KS 17-02667) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MO 2009024879) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2026-04-24 |